Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Updated: Oct 19 2021


  • Introduction
    • Spread of a neoplasm to distant tissues
    • Cellular requirements
      • invasive carcinoma progression that reaches a blood or lymph vessel
      • increased angiogenesis at metastatic foci
      • decreased adhesion to fibronectin, collagen, and laminin
      • ability to survive in distant tissue
    • May spread hematogenously or via lymphatics
      • sarcomas most commonly spread via blood
      • carcinomas most commonly spread via lymphatics
        • most notable exceptions include renal cell carcinomas, follicular carcinomas of the thyroid, and hepatocellular carcinoma
          • all prefer hematogenous spread
    • If neoplasm is multifocal and well-circumscribed, strongly consider metastasis
      • multiple independent cancers are rare
    • Most common sites of metastasis include
      • lung
      • liver
        • metastasis much more common than primary tumors
      • brain
        • metastasis equivalent in frequency to primary tumors
      • bone
        • metastasis much more common than primary tumors
      • lymph nodes are the most common site of metastasis
    • These organs receive a large proportion of blood supply making metastatic seeding more likely in these areas
  • Metastasis to brain
    • Due to blood flow patterns and masses normally present at gray-white border
    • Primary tumors that metastasize to brain include
      • lung > breast > skin (melanoma) > kidney (renal cell carcinoma) > GI
        • pulmonary circulation immediately enters the brain once leaving left heart
  • Metastasis to liver
    • The liver and lung are the most common sites of metastasis after the regional lymph nodes
    • Primary tumors that metastasize to the liver include
      • colon > stomach > pancreas > breast > lung
        • colon drained by portal vein which empties into liver
  • Metastasis to bone
    • Primary tumors that metastasize to the bone include
      • prostate = breast > thyroid > testes > lung > kidney
      • vertebrae seeded by Batson's venous plexus
    • Metastasis to bone may be bone forming (blastic) or bone destructive (lytic)
      • lung = lytic
        • presents with hypercalcemia
      • prostate = blastic
        • presents with high alkaline phosphatase
      • breast = both lytic and blastic
1 of 0
1 of 3
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options